Mercodia Iso-Insulin ELISA

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Mercodia
Iso-Insulin ELISA
Directions for Use

10-1128-01
REAGENTS FOR 96 DETERMINATIONS

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Manufactured by

Mercodia AB, Sylveniusgatan 8A,
SE-754 50 Uppsala,
Sweden
EXPLANATION OF SYMBOLS USED ON LABELS

                       Reagents for 96 determinations

            ∑ = 96

                       Expiry date

                       Store between 2–8°C

                       Lot No.

                       For in vitro diagnostic use

© Mercodia 2008-2011
INTENDED USE
Mercodia Iso-Insulin ELISA provides a method for the quantitative determination of insulin in
human serum or plasma.

SUMMARY AND EXPLANATION OF THE TEST
Insulin is the principal hormone responsible for the control of glucose metabolism. It is synthe-
zised in the ß-cells of the islets of Langerhans as the precursor, proinsulin, which is processed to
form C-peptide and insulin. Both are secreted in equimolar amounts into the portal circulation.
The mature insulin molecule comprises two polypeptide chains, the A chain and B chain (21 and
30 amino acids respectively). The two chains are linked together by two inter-chain disulphide
bridges. There is also an intra-chain disulphide bridge in the A chain.
   Secretion of insulin is mainly controlled by plasma glucose concentration, and the hormone
has a number of important metabolic actions. Its principal function is to control the uptake and
utilization of glucose in peripheral tissues via the glucose transporter. This and other hypogly-
caemic activities, such as the inhibition of hepatic gluconeogenesis and glycogenolysis are coun-
teracted by the hyperglycaemic hormones including glucagon, epinephrine (adrenaline), growth
hormone and cortisol.
   Insulin concentrations are severely reduced in insulin-dependent diabetes mellitus (IDDM)
and some other conditions such as hypopituitarism. Insulin levels are raised in non-insulin-
dependent diabetes mellitus (NIDDM), obesity, insulinoma and some endocrine dysfunctions
such as Cushing’s syndrome and acromegaly.

PRINCIPLE OF THE PROCEDURE
Mercodia Iso-Insulin ELISA is a solid phase two-site enzyme immunoassay. It is based on the
direct sandwich technique in which two monoclonal antibodies are directed against separate
antigenic determinants on the insulin molecule. During incubation insulin in the sample react
with peroxidase-conjugated anti-insulin antibodies and anti-insulin antibodies bound to micro-
titration well. A simple washing step removes unbound enzyme labeled antibody. The bound
conjugate is detected by reaction with 3,3’,5,5’-tetramethylbenzidine. The reaction is stopped by
adding acid to give a colorimetric endpoint that is read spectrophotometrically.

WARNINGS AND PRECAUTIONS
•      For in vitro diagnostic use.
•      The contents of this kit and their residues must not be allowed to come into contact with
       ruminating animals or swine.
•      The Stop Solution in this kit contains 0.5 M H2SO4. Follow routine precautions for hand-
       ling hazardous chemicals.
•      All patient specimens should be handled as of capable of transmitting infections.

                                                                                                  3
MATERIAL REQUIRED BUT NOT PROVIDED
•      Pipettes for 25, 50 and 200 μL (repeating pipettes preferred for addition of enzyme
       conjugate 1X solution, Substrate TMB and Stop Solution).
•      Beakers and cylinders for reagent preparation.
•      Redistilled water.
•      Microplate reader with 450 nm filter.
•      Plate shaker (The recommended velocity is 700–900 cycles per minute, orbital move-
       ment).
•      Microplate washing device.

REAGENTS
Each Mercodia Iso-Insulin ELISA kit (10-1128-01) contains reagents for 96 wells, sufficient for
43 samples and one calibrator curve in duplicate. For larger series of assays, use pooled reagents
from packages bearing identical lot numbers. The expiry date for the complete kit is stated on
the outer label. The recommended storage temperature is 2–8°C.
 Coated Plate                       1 plate          96 wells           Ready for Use
 Mouse monoclonal anti-insulin                       8-well strips
 For unused microplate strips, reseal the bag using adhesive tape, store at 2–8°C and use
 within 8 weeks.
 Calibrators 1, 2, 3, 4              4 vials            1000 µL             Ready for Use
 Recombinant human insulin
 Color coded yellow
 Concentration stated on vial label.
 Calibrator 0                         1 vial            5 mL                Ready for Use
 Color coded yellow
 Enzyme Conjugate 11X            1 vial             600 µL                  Preparation,
 Peroxidase conjugated mouse monoclonal anti-insulin                        see below
 Enzyme Conjugate Buffer              1 vial            6 mL                Ready for use
 Color coded blue
 Wash Buffer 21X          1 bottle 50 mL                                   Dilute with 1000 mL
 Storage after dilution: 			                                               redistilled water to
 2-8°C for 8 weeks.        		                                              make wash buffer
 			                                                                       1X solution.
 Substrate TMB                        1 bottle          22 mL               Ready for Use
 Colorless solution
 Note! Light sensitive!
 Stop Solution                        1 vial            7 mL                Ready for Use
 0.5 M H2SO4

4
Preparation of enzyme conjugate 1X solution
Prepare the needed volume of enzyme conjugate 1X solution by dilution of Enzyme Conjugate
11X (1+10) in Enzyme Conjugate Buffer or according to the table below. When preparing en-
zyme conjugate 1X solution for the whole plate, pour all of the Enzyme Conjugate Buffer into
the Enzyme Conjugate 11X vial. Mix gently.
                                 Enzyme                         Enzyme
 Number of strips                Conjugate 11X                  Conjugate Buffer
 12 strips                       1 vial                         1 vial
 8 strips                        350 μL                         3.5 mL
 4 strips                        200 μL                         2.0 mL
Storage after dilution: 2-8°C for 8 weeks.

SPECIMEN COLLECTION AND HANDLING
Serum
Collect blood by venipuncture, allow to clot, and separate the serum by centrifugation. Samples
can be stored at 2–8°C up to 24 hours. For longer periods store samples at –20°C. Avoid
repeated freezing and thawing.

Plasma
Collect blood by venipuncture into tubes containing heparin or EDTA as anticoagulant, and
separate the plasma fraction. Samples can be stored at 2–8°C up to 24 hours. For longer periods
store samples at –20°C. Avoid repeated freezing and thawing.

Preparation of samples
Samples containing >100 mU/L should be diluted e.g. 1/10 v/v with Calibrator 0.

                                                                                             5
TEST PROCEDURE
All reagents and samples must be brought to room temperature before use.
Prepare a calibrator curve for each assay run.

1.    Prepare enzyme conjugate 1X solution and wash buffer 1X solution.
2.    Prepare sufficient microplate wells to accommodate Calibrators and samples in duplicate.
3.    Pipette 25 μL each of Calibrators and samples into appropriate wells.
4.    Add 50 μL enzyme conjugate 1X solution to each well.
5.    Incubate on a plate shaker for 1 hour (700-900 rpm) at room temperature (18–25°C).
6.    Wash 6 times with 700 µL wash buffer 1X solution per well using an automatic plate
      washer with overflow-wash function, after final wash, invert and tap the plate firmly
      against absorbent paper. Do not include soak step in washing procedure.
      Or manually,
      discard the reaction volume by inverting the microplate over a sink. Add 350 µL
      wash buffer 1X solution to each well. Discard the wash buffer 1X solution, tap firmly
      several times against absorbent paper to remove excess liquid. Repeat 5 times. Avoid
      prolonged soaking during washing procedure.
7.    Add 200 μL Substrate TMB.
8.    Incubate for 15 minutes at room temperature (18–25°C)
9.    Add 50 μL Stop Solution to each well.
      Place plate on a shaker for approximately 5 seconds to ensure mixing.
10.   Read optical density at 450 nm and calculate results.
      Read within 30 minutes.

Note! To prevent contamination between the conjugate and substrate, separate pipettes are
recommended.

6
INTERNAL QUALITY CONTROL
Commercial controls such as Mercodia Diabetes Antigen Control (10-1134-01/10-1164-01)
and/or internal serum pools with low, intermediate and high insulin concentrations should rou-
tinely be assayed as samples, and results charted from day to day. It is good laboratory practice
to record the following data for each assay: kit lot number, dilution and/or reconstitution dates
of kit components, OD values for the blank, Calibrators and controls.

CALCULATION OF RESULTS
Computerized calculation
The concentration of insulin is obtained by computerized data reduction of the absorbance for
the Calibrators, except for Calibrator 0, verus the concentration using cubic spline regression.

Manual calculation
1.       Plot the absorbance values obtained for the Calibrators, except Calibrator 0, against the
         insulin concentration on a log-log paper and construct a calibrator curve.
2.       Read the concentration of the samples from the calibrator curve.

Example of results
 Wells                     Identity                A450                    Mean conc. mU/L

 1A–B                      Calibrator 0            0.066/0.067
 1C–D                      Calibrator 1*           0.084/0.087
 1E–F                      Calibrator 2*           0.161/0.165
 1G–H                      Calibrator 3*           0.595/0.599
 2A–B                      Calibrator 4*           2.377/2.347
 2C–D                      Sample 1                0.270/0.272             16.4
 2E–F                      Sample 2                1.146/1.192             53.6
 2G–H                      Sample 3                2.044/2.150             92.7

*Concentration stated on vial lable.

                                                                                                7
Calibrator curve
A typical calibrator curve is shown here. Do not use this curve to determine actual assay results.

                  10

                   1
 O.D. (450 nm)

                  0,1

                 0,01
                        1              10                          100
                                  Insulin (mU/L)

LIMITATIONS OF THE PROCEDURE
As with all diagnostic tests, a definitive clinical diagnosis should not be based on the results of
a single test, but should be made by the physician after all clinical findings have been evaluated.
Application of this test to individuals already undergoing insulin therapy is complicated by
formation of anti-insulin antibodies that are capable of interfering in the assay.
   Grossly lipemic, icteric or hemolyzed samples do not interfere in the assay. However, hemo-
lysis in serum and plasma samples may result in a degradation of insulin. The degradation is
dependent on time, temperature and the hemoglobin concentration. Keep hemolyzed samples
cold or on ice to prevent the insulin degradation.

EXPECTED VALUES
Good practice dictates that each laboratory establishes its own expected range of values. The fol-
lowing results may serve as a guide until the laboratory has gathered sufficient data of its own.
   Mean fasting levels for 137 tested, apparently healthy individuals, were 10 mU/L, a median
of 7 mU/L and a range, corresponding to the central 95% of the observations, of 2–25 mU/L.

8
PERFORMANCE CHARACTERISTICS
Detection limit
The detection limit is 1 mU/L calculated as two standard deviations above the Calibrator 0.

Recovery
Recovery upon addition is 101%.

Hook effect
Samples with a concentration of up to at least 2000 mU/L can be measured without giving
falsely low results.

Precision
Each sample was analyzed in 4 replicates on 8 different occasions.
                                                  Coefficient of variation
                 Mean value
 Sample          mU/L            within assay %     between assay %          total assay %

 1               15.9            3.0                3.9                      4.9
 2               53.2            2.8                3.0                      4.1
 3               90.9            3.2                3.0                      4.4

Specificity
Insulin                                           100%
Insulin lispro                                     89%
Insulin aspart                                     80%
Insulin detemir                                    22%
Insulin glargin                                    44%
Insulin glulisine                                100%
C-peptide                                       < 0.1%
Proinsulin                                         54%
Proinsulin des (31-32)                             58%
Proinsulin split (32-33)                           56%
Proinsulin des (64-65)                             66%
Proinsulin split (65-66)                           78%
IGF-I                                          < 0.02%
IGF-II                                         < 0.02%
Rat insulin                                        71%
Mouse insulin                                      49%
Porcine insulin                                   306%
Ovine insulin                                     131%
Bovine insulin                                     58%

                                                                                              9
CALIBRATION
Mercodia Iso-Insulin ELISA kit is calibrated against 1st International Reference Preparation
66/304 for human insulin.

CONVERSION FACTOR
1 μg/L = 23 mU/L; 1 mU/L = 6 pmol/L

WARRANTY
The performance data presented here was obtained using the procedure indicated. Any change
or modification in the procedure not recommended by Mercodia AB may affect the results, in
which event Mercodia AB disclaims all warranties expressed, implied or statutory, including the
implied warranty of merchantability and fitness for use.
   Mercodia AB and its authorized distributors, in such event, shall not be liable for damages
indirect or consequential.

REFERENCES
Hedman CA, Lindstrom T, Arnqvist HJ (2001) Direct comparison of insulin lispro and aspart
shows small differences in plasma insulin profiles after subcutaneous injection in type 1 diabetes.
Diabetes Care 24:1120-1121
Heise T, Nosek L, Biilmann Ronn B, Endahl L, Heinemann L, Kapitza C, Draeger E (2004) Lower
Within-Subject Variability of Insulin Detemir in Comparison to NPH Insulin and Insulin Glargine
in People With Type 1 Diabetes. Diabetes 53:1614-1620
Lindstrom T, Hedman CA, Arnqvist HJ (2002) Use of a novel double-antibody technique to des-
cribe the pharmacokinetics of rapid-acting insulin analogs. Diabetes Care 25:1049-1054

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SUMMARY PROTOCOL SHEET

                                                                                         X-O Graf Tryckeri AB
                         Mercodia Iso-Insulin ELISA

Add Calibrators, controls and samples     25 µL

Add enzyme conjugate 1X solution          50 µL

Incubate                                  1 hour at 18-25°C on a plate shaker

Wash plate with wash buffer 1X solution   6 times

Add Substrate TMB                         200 µL

Incubate                                  15 minutes at 18-25°C

                                          50 μL
Add Stop Solution
                                          Shake for 5 seconds to ensure mixing

Measure A450                              Evaluate results

                                                                              31-3112
                                                                          Version 10.0
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